ACR 2020 Tweet by Mrinalini Dey

Glucocorticoids are the cornerstone of initial vasculitis treatment, used to rapidly control inflammation and protect vital organs. EULAR has recommendations that cover glucocorticoid use in ANCA associated vasculitides (AAV) and large vessel vasculitis, including giant cell arteritis (GCA).1,2 But the evidence base continues to grow about their use – especially over the long term.

EULAR recommends a combination of glucocorticoids with either rituximab or cyclophosphamide for remission induction in life-threatening or organ-threatening AAV, followed by gradual tapering of glucocorticoids.

Avacopan (Tavneos), the complement pathway inhibitor for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), appeared strongly effective in an Italian registry study -- a step, maybe, toward setting to rest questions about its efficacy, if not its safety.